Conclusion

Improving Patient Safety in Long-Term Care Facilities, Module 1

In Summary

The ability to detect change in a resident's condition is important because it can prevent illness from getting worse. Nursing staff know the residents best; therefore they are the best qualified to notice when there is a change in a resident's condition. Detecting change depends on all nursing staff (nursing assistants/licensed nurses) being alert to changes and ready to share their observations and respond to the changes.

In order to properly assess a change, it is necessary to know the resident's normal (baseline) condition, assess the change and compare it with the baseline, and know which changes might be signs of illness. When there is a change in condition in an older person, it usually is less obvious than it would be in a younger person, and it could mean many different things.

Changes to watch for include those affecting the way a resident walks, urination and bowel patterns, skin changes, level of weakness, falls, vital signs, demeanor, appetite, sleeping, speech, confusion or agitation, and resident complaints of pain. It may be necessary to report a change repeatedly.